Organization
HIDDEN PINE FAMILY PRACTICE INC
Active
Organization
HIDDEN PINE FAMILY PRACTICE INC
Active
Other names
Medical Practice
Organization subpart
No
Provider details
NPI number
Authorized official
ARTHUR OLIVEROS (PRESIDENT)
(331) 269-9896
Entity
Organization
Contact information
Practice address
3540 SEVEN BRIDGES DR STE 100, WOODRIDGE, IL 60517-1254
(331) 269-9896
(888) 388-0996
Mailing address
3540 SEVEN BRIDGES DR STE 100, WOODRIDGE, IL 60517-1254
(847) 420-9664
(888) 388-0996
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
Primary
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
024794778
—
IL
Enumeration date
11/30/2022
Last updated
09/26/2023
Update your record
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